Facelift SurgeryFacelift or rhytidectomy is a cosmetic surgical procedure to create a younger appearance of your face. The procedure can reduce the sagging folds of skin on the cheeks and jawline and gravitational changes in the shape of your face that occur with age. During a facelift, the skin on each side of the face is elevated from underlying fascia pulled back, and tissues below the skin are surgically altered to return the contour of the face to a more youthful shape. Before the flap is sutured closed, excess skin is removed. A neck lift (platysmaplasty) is often done in conjunct to facelift to reduce fat deposits and sagging skin on the neck. Facelift won't decrease fine creases or wrinkles in your skin or damage from sun exposure especially the one above the lips. Other cosmetic procedures can address the appearance or quality of the skin itself such as mesotherapy.
Why it's doneAs you get older, the appearance and shape of your face is altered because of normal age-related changes. Your skin becomes less elastic and looser, and fat deposits decrease in some areas of your face and increase in others. Age-related changes in your face that may be reduced with a facelift include the following:
- Sagging appearance of your cheeks
- Excess skin at your lower jawline (jowls)
- Deepening of the fold of skin from the side of your nose to the corner of your mouth
- Sagging skin and excess fat in the neck (if the procedure includes a neck lift)
ResultsA facelift can give your face and neck a more youthful appearance. Facelift results are not permanent. With age, the facial skin may begin to droop again. In general, a facelift can be expected to last 10 years.
How you prepare
Medical history and examination is very important. Doctor will ask you questions about past and current medical conditions, previous surgeries, previous aesthetic surgeries, complications from previous surgeries, smoking history, and drug or alcohol use. Your surgeon will do a physical exam, may request recent records from your doctor or order a consultation with a specialist if there are any concerns about your ability to undergo surgery. Medication review. Provide the name and dosages of all medications you regularly take, including prescription drugs, over-the-counter drugs, herbal medications, vitamins and other dietary supplements. Facial exam. Your plastic surgeon will take photos of your face from different angles and close-up photos of some features. The surgeon will also examine your bone structure, shape of your face, fat distribution and quality of your skin to determine your best options for face lift surgery. Expectations. Your surgeon will ask questions about your expectations for the outcomes of a facelift. He or she will help you understand how a face lift will likely change your appearance and what a face lift doesn't address, such as fine wrinkles or naturally occurring asymmetry in your face. Before a face lift:
Follow medication directions. You'll receive instructions about what medications to stop taking and when to stop. For example, you'll likely be asked to discontinue any blood-thinning medication or supplement at least two weeks before surgery. Tell to your doctor about what medications are safe to take or whether the dosage should be adjusted. Wash your face and hair. You'll likely be asked to wash your hair and face with a germicidal soap the morning of the surgery. Avoid eating. You'll be asked to avoid eating anything after midnight the night before your face lift. You will be able to drink water and take medications that have been approved by your surgeon. Arrange for help during recovery. If your face lift is done as an outpatient procedure, make plans for someone to drive you home after surgery and stay with you the first night after surgery.
RisksA face lift surgery can cause complications. Some can be managed with appropriate care, medication or surgical correction. Long-term or permanent complications, while rare, can cause significant changes in appearance. The risks include:
- Blood Collection. A collection of blood (hematoma) under the skin that causes swelling and pressure is the most common complication of face lift surgery. Hematoma formation, which usually occurs with 24 hours of surgery, is treated promptly with surgery to prevent damage to skin and other tissues.
- Scarring. Incision scars from a face lift are permanent but typically concealed by the hairline and natural contours of the face and ear. Rarely, incisions can result in raised, red scars. Injections of a corticosteroid medication or other treatments might be used to improve the appearance of scars.
- Nerve injury. Injury to nerves, while rare, can temporarily or permanently affect nerves that control sensation or muscles. Temporary paralysis of a select muscle, resulting in an uneven facial appearance or expression, or temporary loss of sensation can last a few months to a year. Surgical interventions may offer some improvement.
- Hair loss. You might experience temporary or permanent hair loss near the incision sites. Permanent hair loss can be addressed with surgery to transplant skin with hair follicles.
- Skin loss. Rarely, a face lift can interrupt the blood supply to your facial tissues. This can result in skin loss (sloughing). Sloughing is treated with medications, appropriate wound care and, if necessary, a procedure to minimize scarring.
- Blood-thinning medications or supplements. Medications or supplements that thin the blood can affect your blood's ability to clot and increase the risk of hematomas after surgery. These medications include blood thinners (Coumadin, Plavix, others), aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs). Nutritient supplements and herbal teas such as ginseng, Ginkgo biloba, fish oil and others may also increase bleeding and bruises.
- Medical conditions. If you have a medical condition that prevents blood clotting, you won't be able to have a face lift. Other conditions, such as poorly controlled diabetes or high blood pressure, increase the risk of poor wound healing, hematomas and heart complications.
- Smoking. Smoking significantly increases the risk of poor wound healing, hematomas and skin loss after a face lift.
- Weight fluctuation. If you have a history of repeated weight gain and loss — factors that affect the shape of your face and condition of your skin — the outcome of the surgery may not be satisfactory or may be satisfactory for only a short time.
During the surgeryA face lift surgery is usually performed in a hospital. Sometimes the procedure is performed under sedation and local anesthesia, which numbs only part of your body. In other cases, general anesthesia — which renders you unconscious — is recommended. In general, a face lift involves elevating the skin and tightening the underlying tissues and muscles. Fat in the face and neck may be sculpted, removed or redistributed. Facial skin is then re-draped over the newly repositioned contours of the face, excess skin is removed, and the wound is stitched or taped closed. The incisions for the procedure depend on the techniques that will be used and the patient's preferences. Options include:
- A traditional facelift incision starts at your temples in the hairline, continues down and around the front of your ears and ends behind your ears in your lower scalp. An incision might be made under your chin to improve the appearance of your neck.
- A limited incision is a shorter incision that begins in your hairline just above your ear, wraps around the front of your ear, but does not extend all the way into the lower scalp.
- Neck lift incision starts in front of your earlobe and continues around your ear into your lower scalp. A small incision also is made under your chin.
After the procedure
- After a facelift, you may experience:
- Mild to moderate pain
- Drainage from the incisions
- Contact your doctor immediately if you have:
- Severe pain on one side of your face or neck within 24 hours of surgery
- Shortness of breath
- Chest pain
- Irregular heartbeats
- Your incisions will likely be covered with bandages that provide gentle pressure to minimize swelling and bruising. A small tube might be placed under the skin behind one or both of your ears to drain any excess blood or fluid.
- In the first few days after surgery:
- Rest with your head elevated
- Take pain medication as recommended by your doctor
- Apply cool packs to the face to ease pain and reduce swelling
Before - After
Frequently Asked Questions